A blog that takes the reader through the principles of Lean Management and Six Sigma in a practical way. The ultimate goal is to help the medical practice to meet its goal of becoming more efficient in providing care and meeting the patients needs. | Contact Owen Dahl at 832-260-4455 or at his website OwenDahlConsulting.com

Thursday, August 14, 2014

Practical and Gemba

Let’s get practical. Applications of some of the tools we have talked about have produced some interesting results.

A three doctor practice in the Houston area looked at their patient cycle time, improved their scheduling process, shifted tasks between staff members and were able to increase patient visits by four per day.

Tools used: flow chart, run chart (we will see one later), brainstorming.

A large practice in the mid west was reviewing their cash flow. The CEO simply used the “5 why” technique and found out that there was an automatic hold of 14 days on the AR. The reason given finally was that there was a problem with the billing system several years ago and that became the policy.

Key tools used was the 5 why which came in a brainstorming session.

A large oncology group decided to track compliance with care plans, which were developed and agreed upon. They monitored the results and determined that peer pressure and consequences were the best way to see improvement. Compliance increased from 35% to greater than 50% within three months and as of now compliance continues to improve.

Key tools used was cause and effect diagram (we will see one later), flow chart, brainstorming, session with EMR vendor.

There are many more. One of the keys here is the involvement of the staff through brainstorming. It is not possible for one person to fix or solve all your problems. Utilizing staff knowledge and encouraging them to be involved is essential to the success of an efficiency program.

Another key term and concept in Lean is “Gemba” which literally means “the real place”. We think of it as the place where the work is done. It is essential that those involved go to the Gemba to see how, what, why, and/or when things are done.

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About Me

Owen J. Dahl, MBA, FACHE, LSSMBB, has been active in healthcare management for almost 40 years. He received his bachelor’s degree from Concordia College, Moorhead, Minnesota, where he was a member of the first graduating class in the hospital administration program. He then spent more than a decade as a hospital administrator in various facilities in South Dakota. He also served in the United States Air Force.

His move to New Orleans in 1983 brought a major career change. He started a practice management and billing company, which grew to manage 65 physicians in 11 different practices with revenues well over $75 million. In 1993, he advanced to Fellow in the American College of Healthcare Executives with a paper on Total Quality Management and its application to the medical practice. He also received the distinction of becoming the first non-physician member of the Orleans Parish Medical Services Bureau Board of Directors.

Throughout his career, Owen has maintained a passion for education. He developed an adult continuing education program with Loyola University of New Orleans in physician practice management. He also is the original developer of the certification program for the Professional Association of Health Care Office Managers (PAHCOM) and the Institute of Certified Healthcare Business Consultants (ICHBC). The Institute program is currently available online through the National Society of Certified Healthcare Business Consultants (NSCHBC). He has worked with the Louisiana State University Medical School Department of Graduate Medical Education conducting seminars for students, residents, and fellows in physician practice management.